| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCES. | PO BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC | $269K | $11K | $280K | 3.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 3636 AMERICAN RIVER DRIVE SUITE 200 SACRAMENTO, CA 95864 | SUTTER HEALTH PLAN | $28K | $0 | $28K | 4.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS SVCES. | 4371 LATHAM STREET SUITE 101 RIVERSIDE, CA 92501 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $54K | $3K | $57K | 12.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCES. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $23K | $591 | $24K | 5.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 3636 AMERICAN RIVER DRIVE SUITE 200 SACRAMENTO, CA 95864 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $9K | — | $9K | 2.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | PO BOX 2158 RIVERSIDE, CA 92516 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18K | $1K | $19K | 46.47% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,356 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,369 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,102 | $8.5M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,356 | $463K |
| Short-term disability | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 130 | $41K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,356 | $463K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,102 | $8.5M |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,356 | $537K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,356 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.